Understanding and Responding to Challenging Behaviors in Alzheimer’s Disease

People with dementia sometimes behave in ways that other people find puzzling or difficult to handle. There are a number of different behaviors and ways of coping.

Not everyone with dementia will be affected. Each person with dementia is an individual with different needs. Much of their behavior is an attempt to communicate what they want or how they are feeling. Once we understand the reasons why someone is behaving in a particular way, it is easier to find ways of coping.

If the person is unable to tell you how they are feeling, try a number of approaches. Ask for advice from professionals or other caregivers before you become too stressed.

Medication may sometimes be used for these behaviors. These treatments will need very careful monitoring by the doctor and should be reviewed regularly. Ask about the side-effects of any drugs so that if they appear you do not automatically assume that the dementia has become worse.

Always remember that the person you are caring for is not being deliberately difficult. Ask yourself too whether the behavior is really a problem. Make sure that you have support for yourself and breaks when you need them.

Repetitive questioning with Alzheimer's

A person with dementia may ask the same question over and over again. They probably do not remember asking the question or the answer you gave because of their short-term memory loss. Feelings of insecurity or anxiety about their ability to cope may also play a part in a person’s repetitive questioning. Always try to put yourself in their situation and imagine how they might be feeling and what they might be trying to express.

• Try to be tactful when answering. Don’t say: ‘I’ve already told you that’, as this will increase feelings of anxiety. Try to get the person to find the answer for themselves if possible. For example:
  Q ‘Is it lunch time?’ A ‘Have a look at the clock.’
  Q ‘Do we need more milk?’ A ‘Why don’t you look in the fridge?’
• Try to distract the person with an activity if appropriate.
• If you cannot contain your irritation, make an excuse to leave the room for a while.

People with dementia often become anxious about future events and this can lead to repetitive questioning. If this seems to be the case consider telling them that someone is coming to visit or that you are going shopping just before it happens. This will give them less time to worry.

Repetitive phrases or movements with Alzheimer's

Sometimes people with dementia repeat the same phrase or movement many times. You may hear this referred to by medical professionals as ‘perseveration’.

• This may be due to some kind of discomfort. Check that the person is not too hot or too cold, hungry, thirsty or constipated. Contact the GP if there is any possibility that they are ill, in pain or if medication is affecting them.
• They may be finding their surroundings too noisy or too stressful.
• They may be bored and trying to stimulate themselves. Encourage activity. Some people find stroking a pet, going for a walk or listening to favorite music, for example, is very enjoyable.
• It may be the person’s way of soothing themselves. We all have different ways of comforting ourselves.
• It may be due to the damage in the brain.

Simply offer as much reassurance as you can.

Repetitive behavior with Alzheimer's

You may find that the person seems to be constantly doing the same thing such as packing and unpacking a bag or rearranging the chairs in a room.

• This behavior may relate to a former activity or occupation such as traveling, organizing an office or entertaining friends. You may be able to work out what this activity might be. This may help you understand what the person is feeling and trying to do, and may also serve as a basis for conversation.
• The person may be bored and need more activities to stimulate them or more contact with other people.

continue: Shouting and Screaming and Lack of Inhibition

top . pages 1 2 3 4 5 6 7 8 . send to friend . alzheimer's site map

Reviewed: 03/2006